Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | G68836 | CA |
NPI | 1013091388 |
---|---|
Provider Name | Susan I Goldwasser |
First Address | Tiburon, CA 94920-2021 |
Second Address | Tiburon, CA 94920-2021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/07/2007 |